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Despite theoretical postulations that individuals' conformity to masculine norms is differentially related to mental health-related outcomes depending on a variety of contexts, there has not been any systematic synthesis of the empirical research on this topic. Therefore, the authors of this study conducted meta-analyses of the relationships between conformity to masculine norms (as measured by the Conformity to Masculine Norms Inventory-94 and other versions of this scale) and mental health-related outcomes using 78 samples and 19,453 participants. Conformity to masculine norms was modestly and unfavorably associated with mental health as well as moderately and unfavorably related to psychological help seeking. The authors also identified several moderation effects. Conformity to masculine norms was more strongly correlated with negative social functioning than with psychological indicators of negative mental health. Conformity to the specific masculine norms of self-reliance, power over women, and playboy were unfavorably, robustly, and consistently related to mental health-related outcomes, whereas conformity to the masculine norm of primacy of work was not significantly related to any mental health-related outcome. These findings highlight the need for researchers to disaggregate the generic construct of conformity to masculine norms and to focus instead on specific dimensions of masculine norms and their differential associations with other outcomes. (PsycINFO Database Record
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Masculinidad , Trastornos Mentales/psicología , Conformidad Social , Valores Sociales , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Conducta Sexual , Conducta Social , Adulto JovenRESUMEN
Medical trainees and physicians experience high rates of depression, anxiety, suicidal ideation, and burnout. The stigma surrounding mental health may deter help-seeking behaviors and increase informal treatment to maintain anonymity. Invasive health history questions on state medical licensure applications regarding mental health diagnoses and treatment likely increase stigma, reduce help-seeking, and consequently may motivate some applicants to report an inaccurate history to the state medical board. Research on physician mental health, suicide rates, and lack of help-seeking have led to recommendations for changes to licensure questions. In this article, the authors review the language of health history questions, disclosure requirements for applicants, and the potential consequences of disclosing mental health or substance abuse history on state medical licensure applications. They review recent changes to some states' health history questions, using the changes to Florida's licensure application in 2021 as an example, and explore the implications of these changes for reducing stigma and encouraging help-seeking. The authors recommend that state medical boards review and refine licensure applications' health history questions regarding mental health disclosure in ways that strategically address concerns related to stigma, bias, and unwarranted scrutiny. They call for research to examine the impact of such question changes on applicant response accuracy, help-seeking behaviors, and mental health outcomes and stigma. They also recommend that medical schools offer and promote access to mental health services, encourage faculty to normalize help-seeking behaviors, and provide students with information about state licensure processes. Reducing stigma, normalizing trainee and physician experiences, and promoting help-seeking are preliminary steps to promote a culture in academic medicine that prioritizes mental health. In turn, this will encourage trainees and physicians to care for themselves and cultivate physicians who are better equipped to heal and support their patients.
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Médicos , Estudiantes de Medicina , Revelación , Humanos , Licencia Médica , Salud Mental , Médicos/psicología , Estigma SocialRESUMEN
Leptospirosis is a global zoonotic disease. Pathogenic Leptospira species, the causative agent of leptospirosis, colonize the renal tubules of chronically infected maintenance hosts such as dogs, rats and cattle. Maintenance hosts typically remain clinically asymptomatic and shed leptospires into the environment via urine. In contrast, accidental hosts such as humans can suffer severe acute forms of the disease. Infection results from direct contact with infected urine or indirectly, through contaminated water sources. In this study, a quantitative real-time PCR specific for lipL32 was designed to detect the urinary shedding of leptospires from dogs. The sensitivity and specificity of the assay was evaluated using both a panel of pathogenic Leptospira species and clinical microbial isolates, and samples of urine collected from experimentally infected rats and non-infected controls. The lower limit of detection was approximately 3 genome equivalents per reaction. The assay was applied to canine urine samples collected from local dog sanctuaries and the University Veterinary Hospital (UVH) at University College Dublin. Of 525 canine urine samples assayed, 37 were positive, indicating a prevalence of urinary shedding of leptospires of 7.05%. These results highlight the need to provide effective canine vaccination strategies and raise public health awareness.
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Carga Bacteriana/métodos , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/microbiología , Leptospira/aislamiento & purificación , Leptospirosis/veterinaria , Orina/microbiología , Animales , Proteínas de la Membrana Bacteriana Externa/genética , Derrame de Bacterias , ADN Bacteriano/genética , Perros , Hospitales Veterinarios , Irlanda , Leptospirosis/diagnóstico , Leptospirosis/microbiología , Lipoproteínas/genética , Reacción en Cadena de la Polimerasa/métodos , Prevalencia , Ratas , Sensibilidad y EspecificidadRESUMEN
Summary Rats, dogs, cattle, bats and sea lions, exemplify the diversity of mammalian species that can facilitate transmission of the zoonotic disease leptospirosis. The causative agent, pathogenic species of Leptospira, is shed in urine of chronically infected hosts. Direct contact with infected urine, or indirectly with water sources contaminated with infected urine, poses a risk of infection for humans exposed during water-related recreational and occupational activities. New serovars of Leptospira and maintenance hosts continue to be identified. In the western world, incidences of recreational exposure are increasing, while incidences of occupational exposure are decreasing. Adventure travellers returning from tropical regions, are presenting at clinics with symptoms of leptospirosis following participation in high risk activities including white water rafting, triathlons, endurance races and caving. Risks of infection can be reduced with increased awareness of how the disease is contracted, by avoiding contact with high risk water sources and the use of prophylaxis during high risk activities. Molecular techniques can be used to provide risk assessments prior to competition, to supplement epidemiology, and to assess shedding of Leptospira in urine samples.
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Exposición a Riesgos Ambientales , Leptospirosis/transmisión , Recreación , Adulto , Animales , Animales Domésticos , Animales Salvajes , Bovinos , Perros , Femenino , Humanos , Leptospirosis/prevención & control , Masculino , Ratones , Persona de Mediana Edad , Ratas , Factores de Riesgo , RíosRESUMEN
Bevacizumab (bvz) is a first choice anti-angiogenic drug in oncology and is primarily administered in combination with chemotherapy. It has been hypothesized that anti-angiogenic drugs enhance efficacy of cytotoxic drugs by "normalizing" abnormal tumor vessels and improving drug penetration. Nevertheless, the clinical relevance of this phenomenon is still unclear with several studies over recent years suggesting an opposing relationship. Herein, we sought to develop a new computational tool to interrogate anti-angiogenic drug scheduling with particular application in the setting of colorectal cancer (CRC). Specifically, we have employed a mathematical model of vascular tumour growth which interrogates the impact of anti-angiogenic treatment and chemotherapeutic treatment on tumour volume. Model predictions were validated using CRC xenografts which underwent treatment with a clinically relevant combinatorial anti-angiogenic regimen. Bayesian model selection revealed the most appropriate term for capturing the effect of treatments on the tumour size, and provided insights into a switch-like dependence of FOLFOX delivery on the tumour vasculature. Our experimental data and mathematical model suggest that delivering chemotherapy prior to bvz may be optimal in the colorectal cancer setting.
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Inhibidores de la Angiogénesis/uso terapéutico , Neoplasias Colorrectales/tratamiento farmacológico , Esquema de Medicación , Neovascularización Patológica/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bevacizumab/uso terapéutico , Proliferación Celular/efectos de los fármacos , Citotoxinas/uso terapéutico , Fluorouracilo/uso terapéutico , Humanos , Leucovorina/uso terapéutico , Modelos Teóricos , Compuestos Organoplatinos/uso terapéuticoRESUMEN
A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.
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Recent interest in the life and work of Sandor Ferenczi reconsiders his pivotal role within the development of clinical psychoanalysis (Nemes, 1988; Thompson, 1988). Ferenczi's contributions have been linked to therapeutic orientations that include Rogerian humanistic psychology; Kohutian self psychology; the object relational approach of D. W. Winnicott; and interpersonal psychoanalysis (Katz, 1988; Lum, 1988; Rachman, 1988). Among his analysands were such divergent psychoanalytic pioneers as Ernest Jones, Melanie Klein, Michael Balint, Sandor Rado, and Clara Thompson.
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Psicoanálisis/historia , Terapia Psicoanalítica , Contratransferencia , Empatía , Historia del Siglo XX , Humanos , Hungría , Relaciones Profesional-Paciente , Autoimagen , Transferencia PsicológicaRESUMEN
Plasmids containing hybrid genes, in which different Klebsiella pneumoniae nif (nitrogen-fixation) promoters were fused with the structural part of the Escherichia coli lac operon, were introduced into a double auxotrophic derivative of Agrobacterium tumefaciens C58. A study of their expression in the new host was made simple by the inherent inability of A. tumefaciens C58 to produce beta-galactosidase unless provided with the wild-type lac operon of E. coli. As shown by quantitative measurements of the enzyme, all K. pneumoniae promoters were expressed well in A. tumefaciens C58, even under conditions known to repress them. It also has been shown that the activity of K. pneumoniae nif A is essential for the expression of nifHDK even when introduced into A. tumefaciens. After entering the new host the plasmids, the nif genes and the fusion alleles contained in them, remained stable. Possible mechanisms responsible for the constitutive behaviour of nif promoters in A. tumefaciens are discussed.